Fast Track to Coverage: Facilitating Enrollment of Eligible People into the Medicaid Expansion

Beginning January 1, 2014, millions of low-income parents and other adults will become newly eligible for coverage in states implementing the Affordable Care Act’s (ACA’s) expansion of Medicaid to adults with incomes at or below 138% of the federal poverty level (FPL).1 To help states launch the expansion and efficiently enroll eligible individuals, CMS has offered states a series of facilitated enrollment options. These options include strategies, referred to as “fast track enrollment” in this issue brief, that allow states to enroll eligible individuals into coverage using data already available from their Supplemental Nutrition Assistance programs (SNAP) and/or their Medicaid or Children’s Health Insurance Program (CHIP) programs for children. These strategies complement the array of other pathways currently in place to connect Medicaid-eligible individuals to coverage, which include applying directly through state Medicaid agencies or through the new Marketplaces established by the ACA. To date, these fast track enrollment strategies have been implemented in four states: Arkansas,2 Illinois, Oregon, and West Virginia. New Jersey also recently secured approval to implement fast track enrollment and is scheduled to begin implementation in November.

This issue brief provides an overview of the new “fast track” enrollment options, including how they have been implemented, their impacts, and key lessons learned. It is based on a series of interviews with state officials in Arkansas, Illinois, Oregon, and West Virginia conducted by Manatt Health Solutions and the Kaiser Commission on Medicaid and the Uninsured. In sum it finds that

Arkansas, Illinois, Oregon, and West Virginia together have already enrolled more than 223,000 people in coverage through these “fast track” options;

Through these enrollment gains all four states reached a significant share of adults who will be eligible for the Medicaid expansion, providing a major one-time boost toward their enrollment goals;

While implementing the fast track initiatives required upfront investments of time and effort, they paid off by simplifying the application and enrollment process for individuals and staff, as well as by reducing pressures on new eligibility and enrollment systems.

The fast track initiatives have been positively received by both consumers and state enrollment staff.